If completed course of therapy and no response is seen: Needs medical director review

There is no literature to support continued use of combination therapy in non-responders

Dosing:

Administer SQ once weekly. The dose should be given on the same day of each week

Dose Reduction:

If a serious adverse reaction develops, DC or the dosage of PEG-Intron to 1/2 the starting dosage until the adverse event stops or decreases in severity. If intolerance is persistent or reoccurs despite dosage adjustment, DC treatment with PEG-Intron

In the event of neutropenia and thrombocytopenia, the following dose modifications are recommended by the manufacturer:

Dose Reduction with Ribavirin without cardiovascular disease and Hgb <10g/dL or stable CV disease with in Hgb by more than 2g/dL during any 4 weeks of T treatment: dose of ribavirin to 200 mg QAM and 400 mg QPM

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